Ball and socket implants for correction of hammer toes and claw toes

ABSTRACT

A toe bone implant for correction of toe bone deformities is provided. The toe bone implant includes a first portion having a socket portion. The toe bone implant also includes a second portion having a ball portion operatively connected to the socket portion. The toe bone implant is implanted in a joint such that the ball portion is configured to rotate a predetermined amount respective to the socket portion.

CROSS REFERENCES

This application is a divisional of co-pending U.S. patent applicationSer. No. 13/839,573, filed on Mar. 15, 2013, which claims priority ofU.S. Provisional Patent Application Ser. No. 61/747,429, filed on Dec.31, 2012, the entireties of which are incorporated herein by reference.

FIELD

The disclosed devices and methods generally relates to hammer toe andclaw toe correction implants and devices.

BACKGROUND

A hammer toe or contracted toe is a deformity of the proximalinter-phalangeal joint of the second, third, or fourth toe causing it tobe permanently bent and giving it a semblance of a hammer. Initially,the hammer toes are flexible and may be corrected with simple measuresbut, if left untreated, they get fixed and require surgical interventionfor correcting them. People with hammer toe can have corns or calluseson the top of the middle joint of the toe or on the tip of the toe. Theycan also feel pain in their toes or feet and have difficulty in findingcomfortable shoes. A claw toe is a typically a deformity of themetatarsal phalangeal joint of the second, third, fourth, or fifth toecausing unopposed flexion of the proximal inter-phalangeal joint anddistal inter-phalangeal joint in the respective toe and giving it asemblance of a claw.

Various treatment strategies are available for correcting hammer toesand claw toes. First line treatment of hammer toes starts with new shoesthat have soft and spacious toe boxes. Some toe exercises may also beprescribed, to stretch and strengthen the muscles. For example, gentlystretching the toes manually, using the toes to pick up things off thefloor etc. Another line of treatment includes using straps, cushions ornon-medicated corn pads to relieve symptoms. Further, a hammer toe orclaw toe can be corrected by a surgery if the other treatment optionsfail. Surgery can involve inserting screws, wires etc. or other similarimplants in toes to straighten them.

Traditional surgical methods include use of k-wires. But of late, due tovarious disadvantages of using K-wires, compression screws are beingused as an implant. K-wires require pings protruding through end of toesbecause they are temporarily inserted. Because of this, k-wires lead topin tract infections, loss of fixation etc. Other disadvantages ofk-wires include migration of k-wires and breakage, and may thereforerequire multiple surgeries.

Accordingly, there remains a need for developing improved toe boneimplants and methods of correcting toe bone deformities.

BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure will be or become apparent toone with skill in the art by reference to the following detaileddescription when considered in connection with the accompanyingexemplary non-limiting embodiments.

FIG. 1A is a side elevational view, partially in phantom, of a hammertoeimplant formed in accordance with one embodiment of the invention;

FIG. 1B is a perspective exploded view of the hammertoe implant shown inFIG. 1A;

FIG. 1C is a side elevational view, partially in phantom, of thehammertoe implant shown in FIG. 1A;

FIG. 1D is a perspective view of a hammertoe implant assembled inaccordance with another embodiment of the invention;

FIG. 1E is a side elevational view, partially in phantom, of a hammertoeimplant including threaded portions;

FIG. 1F is a side elevational view of a further embodiment of hammertoeimplant formed in accordance with the another embodiment of theinvention including a blade portion and a threaded portion;

FIG. 2A is a side elevational view of an alternative embodiment ofhammertoe implant including a socket portion, having both spherical andcylindrical articulating surfaces;

FIG. 2B is a perspective view of the hammertoe implant shown in FIG. 2A;

FIG. 2C is a side elevational view, partially in phantom, of anassembled hammertoe implant in accordance with FIGS. 2A and 2B;

FIG. 2D is a perspective view of the hammertoe implant shown in FIG. 2C;

FIG. 2E is a side elevational view, partially in phantom, of a hammertoeimplant in accordance with FIG. 2A, including with threaded portions;

FIG. 2F is a side elevational view, partially in phantom, of a hammertoeimplant in accordance with the embodiment of FIG. 2A, having bladeportions;

FIG. 3A is a side elevational, partially exploded, and partially inphantom further embodiment of a hammertoe implant formed in accordancewith the invention having spherical and cylindrical articulatingsurfaces;

FIG. 3B is a perspective view, partially exploded, of the hammertoeimplant shown in FIG. 3A;

FIG. 3C is a side elevational view, partially in phantom, of anassembled hammertoe implant in accordance with FIGS. 3A and 3B;

FIG. 3D is a perspective view of the hammertoe implant shown in FIG. 3C;

FIG. 3E is a side elevational view, partially in phantom, of thehammertoe implant shown in FIGS. 3A-3D including threaded portions;

FIG. 3F is a side elevational view, partially in phantom, of thehammertoe implant shown in FIGS. 3A-3D, and including blade portions;

FIG. 4A is an exploded side elevational view, partially in phantom, of afurther alternative embodiment of hammertoe implant including acylindrical articulating surface and corresponding ball portion;

FIG. 4B is a perspective view of the hammertoe implant shown in FIG. 4A;

FIG. 4C is a side elevational view, partially in phantom, of thehammertoe implant shown in FIGS. 4A and 4B;

FIG. 4D is a perspective view of the hammertoe implant shown in FIG. 4C;

FIG. 4E is a side elevational view, partially in phantom, of a hammertoeimplant in accordance with FIG. 4A showing a threaded portion and ablade portion;

FIG. 5A is a side elevational view, partially in phantom, of a furtheralternative embodiment of hammertoe implant including a ball portion anda socket portion that together accommodate a cross pin;

FIG. 5B is a perspective view of the hammertoe implant shown in FIG. 5A;

FIG. 5C is a side elevational view, partially in phantom, of thehammertoe implant of FIGS. 5A and 5B including a cross pin shown inphantom;

FIG. 5D is a side elevational view, partially in phantom, of thehammertoe implant shown in FIG. 5C but rotated 90° about axis X;

FIG. 6A is a side elevational view, partially in phantom, of yet afurther alternative embodiment of hammertoe implant formed in accordancewith the invention showing a flange portion included in a socket portionto limit rotation of a ball portion;

FIG. 6B is a perspective view of a hammertoe implant shown in FIG. 6A;

FIG. 6C is a side elevational view, partially in phantom, of anassembled hammertoe implant in accordance with FIGS. 6A and 6B;

FIG. 6D is a perspective view of the hammertoe implant shown in FIG. 6C;

FIG. 6E is a side elevational view, partially in phantom, of thehammertoe implant shown in FIGS. 6A-6D with the ball portion rotatedwithin the socket portion at an angle relative to axes X and Y;

FIG. 6F is a perspective view of the hammertoe implant shown in FIG. 6E;

FIG. 6G is a side elevational view, partially in phantom, of a hammertoeimplant shown in FIGS. 6A-6F, showing threaded portions;

FIG. 6H is a side elevational view, partially in phantom, of thehammertoe implant of FIGS. 6A-6F but including a threaded portion and ablade portion.

FIG. 7 is a flow chart illustrating a method of correcting a toe bonedeformity according to embodiments of the present disclosure.

FIG. 8 is a further flow chart illustrating a method for correcting abone joint according to one embodiment of the invention.

DETAILED DESCRIPTION

With reference to the Figures, where like elements have been given likenumerical designations to facilitate an understanding of the drawings,the various embodiments of cyclic deposition and etch methods aredescribed. The figures are not drawn to scale.

The following description is provided as an enabling teaching of arepresentative set of examples. Many changes can be made to theembodiments described herein while still obtaining beneficial results.Some of the desired benefits discussed below can be obtained byselecting some of the features or steps discussed herein withoututilizing other features or steps. Accordingly, many modifications andadaptations, as well as subsets of the features and steps describedherein are possible and can even be desirable in certain circumstances.Thus, the following description is provided as illustrative and is notlimiting.

This description of illustrative embodiments is intended to be read inconnection with the accompanying drawings, which are to be consideredpart of the entire written description. In the description ofembodiments disclosed herein, any reference to direction or orientationis merely intended for convenience of description and is not intended inany way to limit the scope of the present disclosure. Relative termssuch as “lower,” “upper,” “horizontal,” “vertical,”, “above,” “below,”“up,” “down,” “top” and “bottom” as well as derivative thereof (e.g.,“horizontally,” “downwardly,” “upwardly,” etc.) should be construed torefer to the orientation as then described or as shown in the drawingunder discussion. Terms such as “longitudinal” and “lateral” are to beinterpreted relative to one another or relative to an axis ofelongation, or an axis or center of rotation, as appropriate. Theserelative terms are for convenience of description only and do notrequire that the apparatus be constructed or operated in a particularorientation. Terms such as “attached,” “affixed,” “connected” and“interconnected,” refer to a relationship wherein structures are securedor attached to one another either directly or indirectly throughintervening structures, as well as both movable or rigid attachments orrelationships, unless expressly described otherwise. The term“operatively connected” is such an attachment, coupling or connectionthat allows the pertinent structures to operate as intended by virtue ofthat relationship. The term “adjacent” as used herein to describe therelationship between structures/components includes both direct contactbetween the respective structures/components referenced and the presenceof other intervening structures/components between respectivestructures/components. When only a single machine is illustrated, theterm “machine” shall also be taken to include any collection of machinesthat individually or jointly execute a set (or multiple sets) ofinstructions to perform any one or more of the methodologies discussedherein. In the claims, means-plus-function clauses, if used, areintended to cover the structures described, suggested, or renderedobvious by the written description or drawings for performing therecited function, including not only structural equivalents but alsoequivalent structures. The terms “implant” and “device” are usedinterchangeably in this disclosure and such use should not limit thescope of the claims appended herewith.

As used herein, use of a singular article such as “a,” “an” and “the” isnot intended to exclude pluralities of the article's object unless thecontext clearly and unambiguously dictates otherwise.

Improved implants for hammer toe and/or claw toe correction areprovided. Embodiments of the present subject matter provide a surgeonwith a non-rigid construct and fusion of a joint after correction and aperiod of post-operative healing. Some embodiments can provide a rigidconstruct for initial post-operative wound healing and soft tissuerelease/relaxation while permitting predetermined motion back to thejoint following a period of initial post-operative healing. Someembodiments can feature a proximal end of an implant including a ballportion and a distal end of the implant including a socket portion. Aball portion can include a portion of the implant having a surface of asuitable shape, including, but not limited to, a spherical, oval,cylindrical, or ellipsoidal shape, and permitting a predeterminedmovement of the ball portion when operatively connected to the socketportion. The inventors have observed that an implant having a ballportion and a socket portion can provide improved flexibility,stretching and movement at a respective joint post-insertion.

FIG. 1A illustrates a front plan view of a toe bone implant according tosome embodiments of the present disclosure. FIG. 1B illustrates aperspective view of a toe bone implant according to some embodiments ofthe present disclosure. With reference to FIGS. 1A and 1B, an implant100 for correcting hammertoes can include a first portion 130 and asecond portion 110. In the illustrated embodiment, the first portion 130includes a socket portion 140 disposed at an edge of the first portion130. The socket portion 140 can be formed of any suitable material. Forexample, the socket portion 140 can be formed of a polyethylenematerial. In some embodiments, a socket portion 140 material is selectedto permit flexibility in the socket portion 140. In some embodiments,the socket portion 140 can be formed of a first material and theremainder of the first portion 130 can be formed of a second material.For example, the socket portion 140 can be formed of a polyethylenematerial and the remainder of the first portion 130 can be formed of asecond material such as, for example, stainless steel, titanium, orother metals or rigid polymers.

As shown in FIGS. 1A and 1B, the second portion 110 can include a ballportion 120. Ball portion 120 can be formed of any suitable material.For example, ball portion 120 can be formed of a material such asstainless steel, titanium, or other metals or rigid polymers. In someembodiments, the second portion 110, including ball portion 120, can beformed of the same material. In other embodiments, the ball portion 120can be formed of a first material and the remainder of the secondportion 110 can be formed of a second material. In the illustratedembodiment, socket portion 140 can be configured to receive ball portion120. In some embodiments, socket portion 140 and ball portion 120include respective articulating surfaces 145, 125 such that ball portion120 is configured to move a predetermined amount respective to thesocket portion 140 when operatively connected to the socket portion 140.For example, socket portion 140 and ball portion 120 can includerespective articulating surfaces 145, 125 such that ball portion 120 isconfigured to rotate a predetermined amount about an axis of rotationrespective to the socket portion 140 when operatively connected to thesocket portion 140. Ball portion 120 and socket portion 140 can beformed of any suitable shape. For example, a ball portion 120 caninclude an articulating surface 125 of a suitable shape, including, butnot limited to, a spherical, oval, cylindrical, or ellipsoidal shape,and permitting a predetermined movement of the ball portion 120 whenoperatively connected to the socket portion 140. Socket portion 140 caninclude an articulating surface 145 of a suitable shape such as, forexample, a spherical, oval, cylindrical, or ellipsoidal shape, such thatball portion 120 is configured to move a predetermined amount respectiveto the socket portion 140 when operatively connected to the socketportion 140.

FIGS. 1A and 1B illustrate a toe bone implant 100 prior to operativelyconnecting the ball portion 120 and the socket portion 140. In theillustrated embodiment, toe bone implant 100 is shown prior to insertioninto a joint. Toe bone implant 100 can include an edge portion 135 offirst portion 130 and an edge portion 115 of second portion 110. Asshown, respective edge portions 135, 115 are on opposing edges of thesocket portion 140 of first portion 130 and ball portion 120 of secondportion 110. In some embodiments (not shown), implant 100 can include aresorbable portion operatively connected to the first 130 and second 110portions and configured to limit the rotation of the ball portion 120respective to the socket portion 140 for a predetermined period of time.Any suitable resorbable device can be used. For example, a resorbablepin, bridge, or lock out device can be used to limit the rotation of theball portion 120 respective to the socket portion 140 for apredetermined period of time. Any suitable resorbable material can beused to form the resorbable portion. For example, a bioresorbablematerial including, but not limited to, polylactide (PLA),poly-L-lactide (PLLA), polyglycolide (PGA), co-polymers of PLA and PGAincluding PGLA, poly-DL-lactide (PDLLA), co-polymers thereof, or othersuitable bioabsorble polymers, biopolymers or biodegradable polymers canbe used to form the resorbable portion. In some embodiments, aresorbable snap on, lock out device can be used to hold the implant 100in a predetermined initial position for a predetermined period of time.In some embodiments, a resorbable bridge that could cross a joint wherethe implant was inserted can be used to hold the implant 100 in apredetermined initial position for a predetermined period of time. Insome embodiments, the predetermined period of time is an initial healingperiod. For example, an initial healing period could be approximatelysix weeks (e.g. 5-7 weeks). In some embodiments the predetermined periodof time can be a period between approximately 8-12 weeks (e.g. 7-13weeks). However, any suitable predetermined period of time can be used.The inventors have observed that an implant having rigid fixation for apredetermined period of time achieved through the use of a resorbabledevice, and after resorption, permitting a predetermined amount ofrotation of a ball portion 120 of the implant 100 relative to the socketportion 140, can provide significant improvements to patients sufferingfrom hammertoe or claw toe.

Referring now to FIGS. 1C and 1D, a front plan view and a perspectiveview of a toe bone implant 100 are respectively provided afteroperatively connecting the ball portion 120 and the socket portion 140.In the illustrated embodiment, toe bone implant 100 is shown prior toinsertion into a joint. In some embodiments, ball portion 120 can beconfigured to rotate a predetermined amount respective to socket portion140 in a lateral direction (x). In some embodiments, ball portion 120can be configured to rotate a predetermined amount respective to socketportion 140 about a lateral axis (x). In some embodiments, rotation inlateral direction (x) can be referred to as rotation in a plantardirection, e.g. toward the sole, i.e. at a substantially 90 degree anglebetween the front part of the foot and the shin. In some embodiments,ball portion 120 can be configured to rotate a predetermined amountrespective to socket portion 140 in a longitudinal direction (y). Insome embodiments, ball portion 120 can be configured to rotate apredetermined amount respective to socket portion 140 about alongitudinal axis (y). In some embodiments, rotation in longitudinaldirection (y) can be referred to as rotation in a dorsal direction, e.g.toward or away from a shin bone. In some embodiments, ball portion 120can be configured to rotate a predetermined amount respective to socketportion 140 in a longitudinal direction (y) and a lateral direction (x).In some embodiments, ball portion 120 can be configured to rotate apredetermined amount respective to socket portion 140 about alongitudinal axis (y) and a lateral axis (x). In the illustratedembodiment, ball portion 120 is configured to freely rotate respectiveto socket portion 140.

With reference to FIG. 1E, a front plan view of a toe bone implant 100according to some embodiments is provided. As shown in FIG. 1E, aportion of first portion 130 and a portion of second portion 110 can bethreaded 134, 114. The threads 134, 114 may be threaded in substantiallythe same direction or in opposing directions. As ball portion 120 isconfigured to freely rotate respective to socket portion 140, both therespective first 130 and second 110 portions can be threaded into arespective bone canal. As shown, the threaded portion 134, 114 of first130 and second 110 portions can include a plurality of threads disposedalong its respective length. The tip (not shown) of respective threadedportions 134, 114 can be pointed to facilitate the advancement ofthreads 134, 114 into a respective bone. The respective edge portions135, 115 can have any suitable type of interfacing mechanism to accept asuitable implant drivers such as a screw head or the like. In someembodiments, the respective edge portions 135, 115 can include a femaledepression (not shown) adaptable to mate with a driver (not shown)having a male extension. In some embodiments, for example, therespective edge portions 135, 115 1 can have a portion in the shape of ahex whereby a suitable driver has a corresponding hex adapterappropriate to drive the implant 100 into a respective bone.

Referring now to FIG. 1F, a front plan view of an implant 100 is shownaccording to some embodiments of the present disclosure. In theillustrated embodiment, a portion of first portion 130 includes blades136 to improve alignment or implantation while inserting the firstportion 130 into a bone canal. As shown, blade portion 136 includes aplurality of serrated edges on its top and bottom sides. In someembodiments, blade portion 136 can have a width that is greater than itsthickness and can taper to a point. In some embodiments such asembodiments using a resorbable pin, a portion of first portion 130 caninclude blades 136 to improve alignment or implantation while insertingthe first portion 130 into a bone canal. In some embodiments (notshown), a portion of first portion 130 can include barbs 136 to improvealignment or implantation while inserting the first portion 130 into abone canal.

In various embodiments, an implant 100 can be implanted into targetedbones by any suitable method. For example, an implant 100 can beimplanted or installed via a retrograde approach between, for example,proximate and middle phalanxes in a foot. One skilled in the art willunderstand that the method described herein may be applied to the middleand distal phalanxes, respective metatarsals, as well or other adjacentbones. In some embodiments, an implant 100 can be implanted via aretrograde approach between, for example, a phalanx and a metatarsal ina foot. In some embodiments, a driver can be used to implant an implant100 into a joint. For example, a driver can be an elongated instrumentand include one end having an adaptable portion suitable for mating withan implant 100 described above. In some embodiments, the adaptableportion can include a male hexagonal head adaptable to mate to acorresponding female depression in an edge portion 135, 115 of animplant 100. In some embodiments, an opposing end of the driver caninclude a driving pin or trocar and can include a flat modular sectionconfigured to accept a handle or other suitable mechanism to assist asurgeon during installation of an implant 100.

Referring now to FIG. 7, a flow chart showing a method of correcting atoe bone deformity is provided. At block 710, a joint is exposed betweenfirst and second bones. In some embodiments, the joint is a proximalinterphalangeal (PIP) joint. In some embodiments, the joint is a distalinterphalangeal (DIP) joint. In some embodiments, the joint is ametatarsal phalangeal joint. In some embodiments, a toe can be opened toprovide access to a joint between a first bone and a second bone. Forexample, a toe can be opened to provide access to a joint between amiddle phalanx and a proximal phalanx, or, for example, between a distalphalanx and a proximal metatarsal. In some embodiments, an incision ismade to open the joint. In some embodiments, the first and/or secondbones, respectively, may be resected using a bone saw or other tool, ifnecessary. The resected surfaces of the first and/or second bones can bedebrided if necessary. At block 720, bone implant 100 can be insertedinto the joint. Any suitable insertion method can be used. At block 730,an edge portion 135, 115 of respective first 130 and second 110 implantportions is inserted into respective first and second bones. Anysuitable method to insert the respective edge portions 115, 135 intofirst and second bones. For example, an intermedullary canal can bedrilled into one or both of the first and second bones using a drill orother mechanism to an appropriate depth. In some embodiments, a reamercan be used for precise and accurate canal drilling. In someembodiments, a driver can be engaged with an edge portion 135 of thefirst portion 130 of an implant 100 as described above, and an edgeportion 115 of the second portion 110 of the implant 100 can be threadedinto the first bone. In some embodiments, bladed portion 136 of firstportion 130 can be disposed within a slot of a driving adapter and thebody of the driving adapter can be secured in a chuck of a drill orother driving instrument. A drill or other driving instrument can beused to drive threaded portion 114 of second portion 110 into a surfaceof a second bone, for example, a proximal metatarsal. With the threadedportion 114 of second portion 110 of implant 100 disposed within secondbone, a driving adapter can be disengaged from blade portion 136 offirst portion 130 of implant 100.

The first bone, for example a distal phalanx, can be predrilled orbroached using a drill, or other suitable device, to create a hole. Insome embodiments, a reamer can be used for precise drilling orbroaching. The predrilled or broached first bone is then repositionedsuch that the predrilled hole or broach aligns with the blade portion136 of first portion 130 of implant 100. The first bone is then pressedinto engagement with the blade portion 136 of first portion 130. Theserrated edges of blade portion 136 of first portion 130 help tomaintain engagement between first bone and blade portion 136 of firstportion 130 of implant 100. In some embodiments, a ball portion 120 ofsecond portion 110 can be operatively connected to a socket portion 140of first portion 130 in situ. In some embodiments, a ball portion 120 ofsecond portion 110 can be operatively connected to a socket portion 140of first portion 130 prior to insertion of toe implant 100 into thejoint. At block 740, the ball portion 120 is aligned with socket portion140 such that ball portion 120 is configured to rotate a predeterminedamount relative to socket portion 140. In some embodiments (e.g. FIGS.2, 3, 4, 6), a ball portion of a second portion can be operativelyconnected to a socket portion of a first portion in situ. In someembodiments, the respective edge portions of ball portion 120 of secondportion 110 and socket portion 140 of first portion 130 are insertedinto respective first and second bones such that the ball portion 120 isaligned with socket portion 140 and is configured to rotate apredetermined amount relative to the socket portion 140.

With reference now to FIGS. 2A-2F, various plan and perspective views ofan implant 200 according to some embodiments of the present disclosuresare provided. In the illustrated embodiment, the first portion 230 andsecond portion 210 can be inserted (720) into a joint independent ofeach other. The ball portion 220 can be operatively connected to thesocket portion 240 in situ. As shown and described above, socket portion240 is formed of a material flexible enough to allow insertion andoperative connection of the ball portion 220 of second portion 210. Insome embodiments, the force required to insert ball portion 220 intosocket portion 240 is less than the force required to remove ballportion 220 from socket portion 240. As shown in FIGS. 2B-2F, ballportion 220 will not detach from socket portion 240. With reference nowto FIGS. 2B and 2D, both spherical 225, 245 and cylindrical 242articulating surfaces can be provided on the ball portion 220 and socketportion 240 to limit the rotation of the ball portion 220 relative tothe socket portion 240 to dorsi/plantar flexion. In some embodiments,where the predetermined amount of rotation of the ball portion 220relative to socket portion 240 is limited to dorsiflexion, a greateramount of material can be added to the plantar portion of socket portion240 of the first portion 230 of implant 200.

In some embodiments, an open procedure can be used to expose a joint(710), for inserting the implant 200 into the joint, and for soft tissuerelease. As discussed above, first and second bones can be resected insome embodiments. In some embodiments, a reamer can be used to foraccurate and precise drilling of a canal into respective first andsecond bones. As shown in FIG. 2E, first 230 and second 210 portions caninclude respective threaded portions 234, 214. In some embodiments,respective edge portions 235, 215 can be threaded into canals asdescribed above (715) as the first 230 and second 210 portions areimplanted independently and operatively connected in situ. As shown inFIG. 2F, first 230 and second 210 portions can include respective bladedportion 236, 216. In some embodiments, respective edge portions 235, 215can be inserted into respective first and second bones independently andball portion 220 inserted into and operatively connected to socketportion 240 in situ to align ball portion 220 with socket portion 240and configure it to rotate a predetermined amount relative to socketportion 240. In some embodiments (not shown), implant 200 can include aresorbable portion operatively connected to the first 230 and second 210portions and configured to limit the rotation of the ball portion 220respective to the socket portion 240 for a predetermined period of timeas described above.

Referring now to FIGS. 3A-3F, various plan and perspective views ofimplant 300 are provided according to some embodiments of the presentdisclosure. As shown in FIGS. 3B and 3D, both spherical 325, 345 andcylindrical 342 articulating surfaces can be provided on the ballportion 320 and socket portion 340 to limit the rotation of the ballportion 320 relative to the socket portion 340 to dorsi/plantar flexion.In some embodiments, where the predetermined amount of rotation of theball portion 320 relative to socket portion 340 is limited todorsiflexion, a greater amount of material can be added to the plantarportion of socket portion 340 of the first portion 330 of implant 300.As shown in the illustrated embodiments of 2B, 2D, 3B and 3D, there isless dorsal/plantar constraint in the embodiments illustrated in FIGS.3B and 3D and more dorsal/plantar constraint in the embodiments shown inFIGS. 2B and 2D.

In some embodiments, an open procedure can be used to expose a joint(710), for inserting the implant 300 into the joint, and for soft tissuerelease. As discussed above, first and second bones can be resected insome embodiments. In some embodiments, a reamer can be used to foraccurate and precise drilling of a canal into respective first andsecond bones. As shown in FIG. 3E, first 330 and second 310 portions caninclude respective threaded portions 334, 314. In some embodiments,respective edge portions 335, 315 can be threaded into canals asdescribed above (715) as the first 330 and second 310 portions areimplanted independently and operatively connected in situ. As shown inFIG. 2F, first 330 and second 310 portions can include respective bladedportion 336, 316. In some embodiments, respective edge portions 335, 315can be inserted into respective first and second bones independently andball portion 320 inserted into and operatively connected to socketportion 340 in situ to align ball portion 320 with socket portion 340and configure it to rotate a predetermined amount relative to socketportion 340. In some embodiments (not shown), implant 300 can include aresorbable portion operatively connected to the first 330 and second 310portions and configured to limit the rotation of the ball portion 320respective to the socket portion 340 for a predetermined period of timeas described above.

Referring now to FIGS. 4A-4E, various plan and perspective views of animplant 400 are provided according to some embodiments of the presentdisclosure. As illustrated in FIGS. 4A and 4C, ball portion 420 andsocket portion 440 can include respective cylindrical articulatingsurfaces 427, 447 and respective spherical articulating surfaces 445,425 to limit the rotation of the ball portion 420 relative to the socketportion 440 to a predetermined amount. In the illustrated embodiment,interior portion 450 formed in socket portion 440 along with respectivecylindrical articulating surfaces 427, 447 and respective sphericalarticulating surfaces 445, 425 creates a hinge type of implant 400 andlimits rotation of the ball portion 420 relative to socket portion 440to dorsal/plantar flexion. In some embodiments, where the predeterminedamount of rotation of the ball portion 420 relative to socket portion440 is limited to dorsiflexion, a greater amount of material can beadded to the plantar portion of socket portion 440 of the first portion430 of implant 400.

In some embodiments, an open procedure can be used to expose a joint(710), for inserting the implant 400 into the joint, and for soft tissuerelease. As discussed above, first and second bones can be resected insome embodiments. In some embodiments, a reamer can be used to foraccurate and precise drilling of a canal into respective first andsecond bones. In some embodiments (not shown), first 430 and second 410portions can include respective threaded portions (not shown). In someembodiments (not shown), respective edge portions 435, 415 can bethreaded into canals as described above (715) as the first 430 andsecond 410 portions are implanted independently and operativelyconnected in situ. As shown in FIG. 4E, in some embodiments, firstportion 430 can include a bladed portion 436 and second portion 410 caninclude a threaded portion 414 and respective edge portions 435, 415 canbe threaded into canals as described above (715) as the first 430 andsecond 410 portions are implanted independently and operativelyconnected in situ. In some embodiments (not shown), first 430 and second310 portions can include respective bladed portions. In some embodiments(not shown), first 430 and second 310 portions can include respectivebarbed portions. In some embodiments, respective edge portions 435, 415can be inserted into respective first and second bones independently andball portion 420 inserted into and operatively connected to socketportion 440 in situ to align ball portion 420 with socket portion 440and configure it to rotate a predetermined amount relative to socketportion 440. In some embodiments (not shown), implant 400 can include aresorbable portion operatively connected to the first 430 and second 410portions and configured to limit the rotation of the ball portion 420respective to the socket portion 440 for a predetermined period of timeas described above.

Referring now to FIGS. 5A-5D, various plan and perspective views of ahinge type bone implant 500 according to some embodiments of the presentdisclosure are provided. In the illustrated embodiments, the ballportion 520 is inserted into the socket portion 540 prior to insertingthe bone implant 500 into a joint (720). As shown in the illustratedembodiment, a cross pin 560 can be inserted between the ball portion 520and the socket portion 540 to limit rotation of the ball portion 520relative to the socket portion 540 to dorsi/plantar flexion. In someembodiments, the ball portion 520 can be disposed asymmetricallyrelative to the socket portion 540 to further limit rotation to apredetermined amount. In some embodiments, and as shown in FIG. 5C,resorbable cross-pin ends 565 can be included to restrict rotation ofthe ball portion 520 relative to the socket portion 520 for apredetermined period of time as described above. In some embodiments,where the predetermined amount of rotation of the ball portion 520relative to socket portion 540 is limited to dorsiflexion, a greateramount of material can be added to the plantar portion of socket portion540 of the first portion 530 of implant 500.

In some embodiments, an open procedure can be used to expose a joint(710), for inserting the implant 500 into the joint, and for soft tissuerelease. As discussed above, first and second bones can be resected insome embodiments. In some embodiments, a reamer can be used to foraccurate and precise drilling of a canal into respective first andsecond bones. In some embodiments (not shown), one of the first 530 orsecond 510 portions can include a respective threaded portions (notshown) as the implant 500 is assembled prior to insertion into a joint.In some embodiments (not shown), the respective edge portion 435 (or415) of the respective portion including a threaded portion can bethreaded into a respective canal as described above (715). In someembodiments, the other one of the first 530 or second 510 portions ofthe implant 500 can include a bladed portion. In some embodiments, theother one of the first 530 or second 510 portions of the implant 500 caninclude a barbed portion.

With reference now to FIGS. 6A-6H, various plan and perspective views ofan implant 600 according to some embodiments of the present disclosureare provided. In the illustrated embodiments, a flange portion 670 isincluded in socket portion 640 to limit the rotation of the ball portion620 relative to socket portion 640 in the plantar flexion direction. Asshown in FIGS. 6E and 6F, ball portion 620 can be disposedasymmetrically relative to socket portion 640 to further limit therotation of the ball portion 620 relative to socket portion 640 in theplantar flexion direction. As shown in the illustrated embodiment, ballportion 620 and socket portion 640 include respective sphericalarticulating surfaces which provide rotation of the ball portion 620 apredetermined amount relative to the socket portion 640.

As shown in FIG. 6G, in embodiments where the implant 600 is assembledin situ, first portion 630 and second portion 610 can include respectivethreaded portion 634, 614. In embodiments where the implant 600 inassembled prior to insertion into the joint (at block 720), one of thefirst 630 or second 610 portions can include a respective threadedportion (e.g. FIG. 6H and threaded portion 614) and the other one of thefirst 630 or second 610 portions of the implant 600 can include a bladedportion (e.g. FIG. 6H and threaded portion 616). In some embodiments,the other one of the first 630 or second 610 portions of the implant 600can include a barbed portion (not shown). In some embodiments (notshown), implant 600 can include a resorbable portion operativelyconnected to the first 630 and second 610 portions and configured tolimit the rotation of the ball portion 620 respective to the socketportion 640 for a predetermined period of time as described above. Inembodiments having a resorbable portion, a barbed or bladed portion canbe included on the portion of the implant 600 configured for insertioninto the distal bone for improved alignment and implantation.

Referring now to FIG. 8, a flow chart showing a method of correcting atoe bone deformity is provided. At block 810, a joint is exposed betweenfirst and second bones as described above for block 710. In someembodiments, the joint is a proximal interphalangeal (PIP) joint. Insome embodiments, the joint is a distal interphalangeal (DIP) joint. Insome embodiments, the joint is a metatarsal phalangeal joint. At block820, bone implant 100 (200, 300, 400, 500, 600) can be inserted into thejoint as described above for block 720. At block 830, an edge portion ofthe respective first 130 (230, 330, 430, 530, 630) and second 110 (210,310, 410, 510, 610) portions is inserted into the respective first andsecond bones as described above for block 730. At block 840, a ballportion 120 (220, 320, 420, 520, 620) of the second portion 110 (210,310, 410, 510, 610) can be aligned with a socket portion 140 (240, 340,440, 540, 640) of the first portion 130 (230, 330, 430, 530, 630) suchthat the ball portion 120 (220, 320, 420, 520, 620) is configured torotate a predetermined amount relative to the socket portion 140 (240,340, 440, 540, 640) In some embodiments, a ball portion 220 (320, 420,620) of second portion 210 (310, 410, 610) can be operatively connectedto a socket portion 240 (340, 440, 640) of first portion 230 (330, 430,630) in situ. In some embodiments, a ball portion 120 (520, 620) ofsecond portion 110 (510, 610) can be operatively connected to a socketportion 140 (540, 640) of first portion 130 (530, 630) prior toinserting the bone implant 100 (500, 600) into a joint (820). In someembodiments, the respective edge portions of ball portion 120 (220, 320,420, 520, 620) of second portion 110 (210, 310, 410, 510, 610) andsocket portion 140 (240, 340, 440, 540, 640) of first portion 130 (230,330, 430, 530, 630) are inserted into respective first and second bonessuch that the ball portion 120 (220, 320, 420, 520, 620) is aligned withsocket portion 140 (240, 340, 440, 540, 640) and is configured to rotatea predetermined amount relative to the socket portion 140 (240, 340,440, 540, 640).

Although reference has been made to a patient's proximal and distalinterphalangeal joints and metatarsal phalangeal joints, one skilled inthe art will understand that embodiments of the present disclosure maybe implemented for other respective bones including, but not limited toother phalanges/digits and phalangeal/digital joints.

It may be emphasized that the above-described and illustratedembodiments are merely possible examples of implementations and merelyset forth for a clear understanding of the principles of the disclosure.Many variations and modifications may be made to the above-describedembodiments of the disclosure without departing substantially from thespirit and principles of the disclosure. All such modifications andvariations are intended to be included herein within the scope of thisdisclosure and the present disclosure and protected by the followingclaims.

While this specification contains many specifics, these should not beconstrued as limitations on the scope of the claimed subject matter, butrather as descriptions of features that may be specific to particularembodiments. Certain features that are described in this specificationin the context of separate embodiments can also be implemented incombination in a single embodiment. Conversely, various features thatare described in the context of a single embodiment can also beimplemented in multiple embodiments separately or in any suitablesub-combination. Moreover, although features may be described above asacting in certain combinations and even initially claimed as such, oneor more features from a claimed combination can in some cases be excisedfrom the combination, and the claimed combination may be directed to asub-combination or variation of a sub-combination.

As shown by the various configurations and embodiments illustrated inFIGS. 1A-8, improved toe bone implants and methods of correcting toebone deformities have been described.

Some embodiments provide a toe bone implant. The toe bone implantincludes a first portion having a socket portion. The toe bone implantalso includes a second portion having a ball portion operativelyconnected to the socket portion. The toe bone implant is implanted in ajoint such that the ball portion is configured to rotate a predeterminedamount respective to the socket portion.

Some embodiments provide a method of correcting a toe bone deformity.The method includes exposing a joint between first and second bones andinserting a bone implant into the joint. The bone implant includes afirst portion including a socket portion and a second portion includinga ball portion operatively connected to the socket portion. The methodincludes inserting an edge portion of the respective first and secondportions into the respective first and second bones, and aligning theball portion with the socket portion such that the ball portion isconfigured to rotate a predetermined amount relative to the socketportion.

Some embodiments provide a toe bone implant. The toe bone implantincludes a first portion having a socket portion. The toe bone implantincludes a second portion having a ball portion operatively connected tothe socket portion such that the ball portion is configured to rotate apredetermined amount respective to the socket portion. The toe boneimplant also includes a resorbable portion operatively connected to thefirst and second portions and configured to limit rotation of the ballportion respective to the socket portion for a predetermined period oftime.

While various embodiments are described herein, it is to be understoodthat the embodiments described are illustrative only and that the scopeof the subject matter is to be accorded a full range of equivalents,many variations and modifications naturally occurring to those of skillin the art from a perusal hereof.

1-20. (canceled)
 21. A joint implant, comprising: a first portion and asecond portion wherein the first portion is operatively connected to thesecond portion so as to rotate a predetermined amount with respect tothe first portion; and a resorbable portion selected from the groupconsisting of a resorbable pin, a resorbable bridge, a resorbable lockout device, and a resorbable snap-on being operatively connected to thefirst and second portions and configured to limit said rotation for apredetermined period of time.
 22. The joint implant of claim 21, whereinthe first portion is configured to rotate a predetermined amount in alongitudinal direction.
 23. The bone implant of claim 21, wherein thefirst portion is configured to rotate a predetermined amount in alateral direction.
 24. The bone implant of claim 21, wherein the firstportion is configured to freely rotate about an axis of rotation. 25.The bone implant of claim 21, wherein the joint is a proximalinterphalangeal (PIP) joint.
 26. The bone implant of claim 21, whereinthe joint is a metatarsal phalangeal joint.
 27. The bone implant ofclaim 21, wherein one or more of the first or second portions comprisesa threaded edge portion.
 28. The bone implant of claim 21, wherein oneor more of the first or second portions comprises an edge portioncomprising blades.
 29. A joint implant, comprising: a first portion anda second portion wherein the first portion is operatively connected tothe second portion so as to rotate a predetermined amount withrespective to the first portion; and a resorbable portion operativelyconnected to the first and second portions and configured to limit saidrotation a predetermined period of time of approximately 8 to 12 weeksand when the implant is implanted in a joint.
 30. A method of correctinga joint, comprising: exposing a joint between first and second bones;inserting a bone implant into the joint, the bone implant comprising afirst portion and a second portion operatively connected to one another;inserting an edge portion of the respective first and second portionsinto the respective first and second bones; and aligning the firstportion with the second portion such that the first portion isconfigured to rotate a predetermined amount relative to the secondportion.
 31. The method of claim 30, wherein the first bone is a firstphalanx.
 32. The method of claim 30, wherein the second bone is a secondphalanx.
 33. The method of claim 30, wherein the second bone is a firstmetatarsal.
 34. The method of claim 30, further comprising: resecting anend of at least one of the first and second bones.
 35. The method ofclaim 30, further comprising: creating a hole in the end of the at leastone of the first and second bones.
 36. The method of claim 30, furthercomprising: operatively connecting the first portion and the secondportion in situ.
 37. The method of claim 36, further comprising:operatively connecting the first portion and the second portion afterperforming the step of inserting the edge portion of the respectivefirst and second portions into the respective first and second bones.